Bill Gatton College of Pharmacy, East Tennessee State University, Mountain Home, TN.
Am J Health Syst Pharm. 2019 Jul 2;76(14):1019-1027. doi: 10.1093/ajhp/zxz095.
This review summarizes the available evidence concerning direct oral anticoagulant (DOAC) use to treat venous thromboembolism (VTE) in patients with cancer as well as pertinent safety data on the use of DOACs in patients with both cancer and atrial fibrillation.
The introduction of DOACs into clinical practice changed the way thrombotic complications are managed and prevented in diverse patient populations, including VTE and atrial fibrillation. Low-molecular-weight heparins have been the standard of care for treating VTE in cancer patients due to superiority over vitamin K antagonists in preventing recurrent VTE. Therefore, widespread DOAC use for VTE in patients with active cancer has not been adopted.
Recent randomized clinical trials (SELECT-D, Hokusai VTE Cancer) have provided evidence that DOACs may have a role in treating VTE in cancer patients.
本综述总结了现有关于直接口服抗凝剂（DOAC）治疗癌症患者静脉血栓栓塞症（VTE）的证据，以及 DOAC 在癌症合并心房颤动患者中的使用相关安全性数据。
DOAC 的引入改变了包括 VTE 和心房颤动在内的多种患者人群中血栓并发症的管理和预防方式。由于在预防复发性 VTE 方面优于维生素 K 拮抗剂，低分子肝素一直是癌症患者 VTE 治疗的标准护理方法。因此，广泛使用 DOAC 治疗活动性癌症患者的 VTE 尚未被采纳。
最近的随机临床试验（SELECT-D、Hokusai VTE Cancer）提供了证据表明，DOAC 可能在治疗癌症患者的 VTE 中发挥作用。
